Differential biomarker responses of hemolysis, inflammation, and myocardial injury after pulsed-field pulmonary vein isolation: balloon-in-basket vs. circular catheter systems - Summary - MDSpire
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Differential biomarker responses of hemolysis, inflammation, and myocardial injury after pulsed-field pulmonary vein isolation: balloon-in-basket vs. circular catheter systems
To assess changes in biomarkers of hemolysis, inflammation, and biochemical myocardial injury using two PFA systems: balloon-in-basket (BiB) and circular catheter (PS), specifically measuring leukocytes, CRP, LDH, haptoglobin, and others.
Key Findings:
Both BiB and PS systems achieved acute PVI with significant increases in leukocytes, CRP, LDH, troponin, and CK without inter-group differences.
BiB required fewer applications (16 vs. 32, p < 0.001) and more contrast (45 vs. 30 mL, p < 0.001).
Haptoglobin decreased significantly in both groups, more pronounced with PS (Δ −13 vs. −4 mg/dL, p = 0.090).
Renal function remained stable overall, with one PS patient developing acute kidney injury.
In the BiB group, Δ-Hemoglobin correlated inversely with application number (p = 0.046). In the PS group, Δ-Troponin and Δ-CK correlated positively (p < 0.05).
Interpretation:
Despite comparable overall biomarker responses, the differences in haptoglobin decline and the occurrence of a transient acute kidney injury in the PS group suggest potential variations in systemic responses between the two PFA systems, warranting further investigation.
Limitations:
The study was non-randomized and conducted at a single center, which may introduce biases.
The sample size was limited to 40 patients.
Conclusion:
The clinical relevance of the findings remains uncertain, highlighting the need for further investigation in larger studies to clarify the implications of these biomarker variations.
by Jan-Per Wenzel, Raed Abdessadok, Charlotte Eitel, Sorin Popescu, Suzanne de Waha, Tanja Zeller, Karl-Heinz Kuck, Roland Richard Tilz, Sascha Hatahet
